| NPI | 1578041398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA CLICKENER Occupational Therapist 254-781-3447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2018-08-02 |